WALANT (Wide Awake Local Anesthesia No Tourniquet)
OVERVIEW
Wide Awake Local Anesthesia No Tourniquet (WALANT) is a technique for hand and wrist surgery that uses local anesthesia. This technique offers many advantages over standard procedures including no general anesthesia, better surgical outcomes and lower costs. With the appropriate operation, WALANT can be a better solution that may cost less.
DESCRIPTION
WALANT is a new type of local anesthesia for various hand and wrist surgery procedures. Until recently, certain hand and wrist surgeries were performed using a tourniquet to control blood to improve the surgeon’s visibility of the operated area. Tourniquets, however, are uncomfortable and unpleasant for patients. In the past, this discomfort was reduced by sedating patients with general anesthetics. (General anesthetics are used to cause a patient to remain unconscious during surgery.)

WALANT eliminates the need for tourniquets and general anesthesia (sedation) by using two medications administered locally for a safe, painless surgery. Lidocaine blocks pain, and epinephrine stops bleeding. Epinephrine acts as a vasoconstrictor to control bleeding, which is why the use of tourniquets can be eliminated during the procedure. While not every hand and wrist surgery can be performed with WALANT, there are many that qualify, some of which include:
- Nerve compression
- Tendon disorders or repairs
- Carpal tunnel release
- Trigger finger release
- Finger sensory block
- Soft-tissue Finger lesions
- PIP fusions
- Thumb MCP fusions
- Collateral ligament tears of the MCP joint
- Dupuytren contractures
- Flexor tendon repairs
- Trapeziectomy or Bennett fracture
- Metacarpal fractures
- Ligament repairs
- Fracture fixation
- Arthritic conditions
- Mass removal

ADVANTAGES
The patient advantages of using WALANT are:
- No cost/ time lost for preoperative testing for sedation, since there is no general sedation.
- Less expensive procedure. Since there is no general sedation, the procedure is not as costly.
- Less time at the hospital or surgery center for the procedure as there is little to no recovery time from the surgical procedure.
- If desired, patients can see and feel repaired structures working during the surgery after a loss of function, which helps motivate the patient in post-operative therapy and recovery.
- No need for a tourniquet.
- No need to fast or change medication schedules which is particularly helpful for diabetics.
- Increased safety. The elimination of general sedation increases safety. All research shows that WALANT is safe.
Overall, WALANT provides a less expensive and easier surgical experience, making it an effective choice for patients.
NEXT STEPS
Contact your Florida Orthopaedic Institute hand and wrist surgeon to find out if your surgery can be done with WALANT.
Areas of Focus
- Hand & Wrist
- Basal Joint Surgery
- Carpal Tunnel Syndrome
- Colles’ Fractures (Broken Wrist)
- De Quervain's Tenosynovitis
- Dupuytren’s Disease
- Finger Dislocation
- Flexor Tendonitis
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- Hand & Finger Replantation
- Hand Nerve Decompression
- Hand Skin Grafts
- Nerve Pain
- Peripheral Nerve Surgery (Hand) Revision
- Revascularization of the Hand
- Rheumatoid Arthritis Of The Hand
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Trigger Finger
- Ulnar Neuritis
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Sprains
- Wrist Tendonitis
The following Florida Orthopaedic Institute physicians specialize in WALANT:
Specialties
- Achilles Tendinitis - Achilles Insertional Calcific Tendinopathy (ACIT)
- Achilles Tendon Rupture
- Achilles Tendonitis
- ACL Injuries
- ALIF: Anterior Lumbar Interbody Fusion Surgery
- Ankle Fracture Surgery
- Ankle Fractures (Broken Ankle)
- Ankle Fusion
- Arthritis & Adult Reconstruction Surgery
- Arthroscopic Chondroplasty
- Arthroscopic Debridement of the Elbow
- Arthroscopic Rotator Cuff Repair
- Artificial Disc Replacement (ADR)
- Aspiration of the Olecranon Bursa
- Avascular Necrosis (Osteonecrosis)
- Back Surgery Types
- Bankart Repair
- Basal Joint Surgery
- Bicep Tendon Tear
- Bicep Tenodesis
- Bioinductive Implant
- Broken Collarbone
- Bunions
- Bursitis of the Shoulder (Subacromial Bursitis)
- Calcific Tendinitis of the Shoulder
- Carpal Tunnel Syndrome
- CARTIVA® Implant For Big Toe Joint Arthritis
- Charcot Joint
- Chiropractic
- Colles’ Fractures (Broken Wrist)
- Community Outreach
- ConforMIS Knee Replacement
- Cubital Tunnel Syndrome
- De Quervain's Tenosynovitis
- Degenerative Disc Disease
- Diffuse Idiopathic Skeletal Hyperostosis (DISH)
- Discitis
- Dislocated Shoulder
- Dupuytren’s Disease
- Elbow
- Elbow Bursitis
- Elbow Injuries in Throwing Athletes
- Epidural Injections for Spinal Pain
- Finger Dislocation
- Flexor Tendonitis
- Foot, Ankle & Lower Leg
- Fractures Of The Shoulder Blade (Scapula)
- Fractures Of The Tibial Spine
- Functional Nerve Transfers of The Hand
- Ganglion Cysts
- General Orthopedics
- Glenoid Labrum Tear
- Golfer's Elbow
- Growth Plate Injuries Of The Elbow
- Hallux Rigidus - Cheilectomy
- Hand & Finger Replantation
- Hand & Upper Extremity
- Hand & Wrist
- Hand Nerve Decompression
- Hand Skin Grafts
- Hip & Thigh
- Hip Arthroscopy
- Hip Dislocation
- Hip Flexor Strains
- Hip Fractures
- Hip Hemiarthroplasty
- Hip Muscle Strains
- Hyperextension Injury of the Elbow
- Iliotibial Band Syndrome
- Interventional Pain Management
- Interventional Spine
- Intraarticular Calcaneal Fracture
- Knee & Leg
- Kyphosis
- Labral Tears Of The Hip (Acetabular Labrum Tears)
- Lateral Collateral Ligament (LCL) Injuries
- Lisfranc Injuries
- LITTLE LEAGUER'S ELBOW (MEDIAL APOPHYSITIS)
- MACI
- MAKO Knee Replacement Surgery
- MAKO Total Hip Replacement
- Mallet, Hammer & Claw Toes
- Medial Collateral Ligament Injuries
- Meniscus Tears
- Metatarsalgia
- Minimally Invasive Spine Surgery
- Morton’s Neuroma
- Muscle Spasms
- NAVIO Surgical System
- Nerve Pain
- Neuromas (Foot)
- Olecranon Stress Fractures
- Orthopaedic Total Wellness
- Orthopedic Trauma
- Osteoarthritis of the Hip
- Osteoporosis
- Outpatient Spine Surgery
- Partial Knee Replacement
- Patellar Fracture
- Pelvic Ring Fractures
- Peripheral Nerve Surgery (Hand) Revision
- Pinched Nerve
- Plantar Fasciitis
- Podiatrist or Orthopaedic Physician?
- Primary Care Orthopedics Sports Medicine
- PROstep™ Minimally Invasive Surgery for Bunions
- Quadriceps Tendon Tear
- Revascularization of the Hand
- Reverse Total Shoulder Replacement
- Revision Knee Surgery
- Rheumatoid Arthritis (RA) of the Shoulder
- Rheumatoid Arthritis Of The Hand
- Robotics
- ROSA® Knee Robotic Surgical Assistant
- Sciatica
- Scoliosis
- Senior Strong
- Shin Splints
- Shoulder
- Shoulder Arthritis
- Shoulder Arthroscopy
- Shoulder Replacement
- Shoulder Socket Fracture (Glenoid Fracture)
- SLAP Tears & Repairs
- Spinal Fusion
- Spine
- Spondylolisthesis and Spondylolysis
- Sports Hernias (Athletic Pubalgia)
- Sports Medicine
- Sprained Ankle
- Sudden (Acute) Finger, Hand & Wrist Injuries
- Targeted Muscle Reinnervation (TMR)
- Tendon Transfers of The Hand
- Tennis Elbow
- Thigh Fractures
- Thigh Muscle Strains
- Total Ankle Replacement
- Total Hip Arthroplasty
- Total Hip Replacement - Anterior Approach
- Total Knee Replacement
- Triceps Tendonitis
- Trigger Finger
- UCL (Ulnar Collateral Ligament) Injuries
- Ulnar Neuritis
- Valgus Extension Overload
- Verilast
- Vertebroplasty
- WALANT (Wide Awake Local Anesthesia No Tourniquet)
- Whiplash and Whiplash Associated Disorder (WAD)
- Wrist Arthroscopy
- Wrist Fractures
- Wrist Sprains
- Wrist Tendonitis